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NYC/Kigali
Off to Rwanda, South Africa, Swaziland & beyond...
Typical ride on a mototaxi in downtown Kigali
Apologies for the poor video quality — moto drivers usually get angry or ask for lots of extra money if they know you’re taking a picture while riding, so I was being very sneaky
My last week in Rwanda was bittersweet. Coming back into the urban orderliness that is Kigali from the wild beauty of northern Rwanda and southern Uganda was disappointing, mixed with the unsettling feeling that a certain phase of my life was ending soon.
I couldn’t decide whether I was ready to leave, sad to go, or, more obviously, some muddled combination of the two. There were a lot of issues at play: I missed my friends and family at home, yet I had also developed some close attachments here in Kigali. I was strangely nervous about re-entry and reverse culture shock, not to mention more broadly being in the midst of some big career and life decisions. Faced with so many conflicting feelings and emotions, I practiced my favorite coping technique: Denial.
Just kidding… sort-of. Instead of dwelling on the obvious, I filled up my last few days with so many activities I couldn’t spend much time moping, and took pictures of day-to-day things I had never thought to document before.
For example, immediately after coming home from Binyoni, I snapped this photo of the house where I spent the second half of my stay:
Hi, Kigali house! Regis, seeing my camera out, asked me to take a picture of him…
And then I had him take one of me in return:
Nice image composition, Regis!
And then, quite suddenly, it was Tuesday evening and it was time to go. Three flights, two meals and 26 hours later, I was walking dazed into my mother’s bearhug in Washington DC, marveling at the speed with which one can jump oceans these days.
I’m not quite ready to write more of a conclusion yet. “How was Africa?” everyone asks. Wonderful, difficult, fantastic, intense, tough: I could add twenty adjectives and still not capture the experience completely. Fourth months in Rwanda, Malawi, Uganda, South Africa, Swaziland and the Nairobi airport, and suddenly I was home.
Looks like I will be going back in November, though… stay tuned for more updates!
Rwanda streetscape
I just finished Philip Gourevitch’s classic book on the Rwandan genocide, in which 800,000 Rwandan Tutsis and moderate Hutus were killed in under 100 days by an extremist Hutu Power government, and it really got me thinking.
Titled “We wish to inform you that tomorrow we will be killed with our families,” Gourevitch’s book not only deftly unpacks the state planning and political tensions that led up to the genocide but also chronicles the aftermath, where international aid seriously prolonged the conflict by inadvertently supplying to genocidaires. Where most works on Rwanda stop with the successful RPF invasion which chased the genocide-perpetrating Hutu Power extremists into exile in the DR Congo, Gourevitch follows the story much further. To be honest, I wish I’d read it before I left — it provides a context for some of the bewildering actions or facts of life which I witnessed, which make more sense in light of recent history.
That’s why I want to reproduce a section here, because I’ve shied away from discussing the genocide thus far. How do you write about an event in which potentially hundreds of thousands of ordinary citizens are believed to have participated as killers, attacking neighbors and close friends with machetes or other blunt instruments in a way that sounds horribly… personal, to those of us raised on the imagery of de-individualizing gas chambers in Nazi Germany? It’s a hard thing to put words to, and frankly, I’m afraid of saying the wrong thing. The topic is also so politically fraught, particularly within Rwanda, that one can become persona non grata in the country just by summarizing the facts in the wrong way. Moreover, it’s extremely impolite to bring it up, and one can imagine that Rwandans would hate little more than having every expat who arrives ask them breathlessly, “What was it like, during the genocide?” Someone once scoffed that the genocide is the only thing most Americans know of Rwanda, and that’s probably true. But while I’ve tried to portray a little bit of life in Rwanda here, without referring too much to the events of 1994, I don’t think my time there - or this writing - would be complete without a bit of that context. That said, I’m still unsure of how to put my own thoughts into words, so I’ll hide behind an excerpt from Gourevitch’s book. Apologies for the length, but I think it’s worth it for those who want a little more detail on the country’s history
[On a side note, I also had a chance to meet Gourevitch when he returned to Rwanda for what seemed like another investigative visit. I’ll definitely keep an eye on any further writings of his]
“When I got depressed in Rwanda, which was often, I liked to go driving. On the road, the country resolved itself in rugged glory, and you could imagine, as the scenes rushed past and the car filled with smells of earth and eucalyptus and charcoal, that the people and their landscape - the people in their landscape - were as they had always been, undisturbed. In the fields people tilled, in the markets they marketed, in schoolyards the girls in bright blue dresses and boys in khaki shorts and safari shorts played and squabbled like children anywhere. Across sweeping valleys, and through high mountain passes, the roadside presented the familiar African parade: brightly clad women with babies bound to their backs and enormous loads on their heads; strapping young men in jeans and Chicago Bulls T-shirts; elderly gents in suits weaving down red-dirt lanes on ancient bicycles; a girl chasing a chicken, tiny tots in ragged smocks whacking cows out of your way with long sticks.
Life.
You knew, by the statistics, that most of the people you saw here Hutu, but you had no idea who was who; whether that girl, who stared blankly at your oncoming car and at the last minute winked and broke into a wide grin, was a massacre survivor, or whether she was a killer, or both, or what. If you stopped to buy a cold drink and a brochette of grilled goat, or to ask directions, a small crowd gathered to stare and offer commentary, reminding you of your exoticism. If you drove around in the northwest, and pulled over to admire the volcanoes, peasants came out of their fields to express approval that you had no greater purpose, at that moment, than to regard their place with pleasure…
Most of Rwanda was once a forest like Nyungwe, a dark knot of vegetation trailed by low thin clouds. But centuries of use had stripped the forest away, and by the time I came along even the steepest slopes were tilled, grazed and toiled over, shaded only on their summit by a vestigial crowd of tall tres. The intensity with which every patch of available land was worked offered evidence of Rwanda’s population density and the attendant competition for resources, and it has been argued that the genocide was driven, in large measure, by basic economic motives: “to the victor go the spoils” and “there isnt’ room for the both of us” - that sort of thing, as if the killing had been a kind of Darwinian population control mechanism.
No doubt, the promise of material gain and living space did move some killers. But why hasn’t Bangladesh, or any other terribly poor and terribly crowded place of the many one might name, had a genocide? Overpopulation doesn’t explain why hundreds of thousands of people agreed to murder nearly a million of their neighbors in the course of a few weeks. Nothing really explains that. Consider all the factors: the precolonial inequalities; the fanatically thorough and hierarchical centralized administration; the radical polarization under Belgian rule; the killings and expulsions that began with the Hutu revolution of 1959;… the RPF attack; the war; the extremism of Hutu Power; the propaganda; the practice massacres; the massive importation of arms; the threat to the Habyarimana oligarchy posed by peace through power sharing and integration; the extreme poverty, ignorance, superstition and fear of a cowed, compliant, cramped peasantry; the indifference of the outside world. Combine these ingredients and you have such an excellent recipe for a culture of genocide that it’s easy to say that it was just waiting to happen. But the decimation had been utterly gratuitous.
And afterward the world was a different place for anyone who chose to think about it. Rwandans have no choice. This was what interested me most about them: not the dead - what can you really say about a million murdered people whom you didn’t know? - but how those who had to live in their absence would do so. Rwanda had the memories and the habits of a long past, yet the rupture in that past had been so absolute that the country I was driving through was actually a place that had never existed before. Scenes of rural life that appeared eternal to me, and that impressed Joseph, the driver, as empty, were neither of those things. The Rwanda I visited in the years after the genocide was a world in limbo.”
[Philip Gourevitch, We wish to inform you that tomorrow we will be killed with our families, pages 178 - 181]
Outside of Kigali, life gets a lot slower and greener, and health care becomes…much more erratic. While there are plenty of well-managed, well-stocked health facilities in rural Rwanda, there are also a minority which operate without regular water or electricity connections, in which staff may not be frequently trained and standard protocol not always followed. I found more of that in Malawi than Rwanda, but more on that in a later post.
Driving past numerous towns in which it seemed that almost everyone was out on the street, I wondered what it would be liked to be based there for some time, instead of the capital.
Many of my coworkers do exactly that, spending Monday through Thursday living up in Burera province and only returning to Kigali on the weekends.
Along the way, we stopped for a mid-morning bite at a small snack shop, where I posed with this photo of Bill Clinton, who was posing with the workers of said snack shop. Very meta, indeed
Finally, we arrived at our destination: the Centre de Sante, or health center, of Nyamugali, only to find that all of the relevant staff were busy hosting a surprise supervisory visit from the Ministry of Health. This is not uncommon in this type of work: arriving at meetings that have been pre-arranged and confirmed several hours in advance, only to find that they have been canceled and no one has called you. It’s frustrating, but it’s surprising how quickly you get used to it.
During our brief stay at the facility, I managed to unobtrusively snap this shot using my auto-timer with my camera peeking out of my bag. That’s my coworker Jacques in the bottom left. Hi Jacques!
As we walked through, many of the waiting people sat straighter or smiled at us. Our host explained to my colleague Mary and myself, “They think you’re doctors, coming to provide good healthcare. That’s because you’re white.” I have never wished more that I had some sort of medical training.
Leaving Nyamugali, we headed up towards the northern part of Burera district. The trip that was only a few kilometers took the better part of an hour and a half, primarily because of the poor condition of the dirt roads.
The scenery, however, was spectacular, especially as we got farther north and the rolling hills gave way to lakes dotted with islands and ominous volcanoes.
Maybe it’s sad, but I love volcanoes!
Eventually we arrived at the Centre de Sante Kinoni and were able to speak to the people we needed, me about vaccines and Jacques/Mary about HIV supply chains.
I can’t share any photos from the inside, but I’m happy to report that this was definitely one of the better run facilities. It was interesting, and humbling as well, to see the circumstances under which healthcare is delivered in much of the country. It’s one thing to read about it from the US; quite another to plan vaccine distribution from the capital; and quite a third to visit the isolated facilities where staff administer care. A good lesson in thankfulness, indeed.
As my time in East Africa wore to a close, I made a list of the most interesting-sounding places I hadn’t been yet, and Lake Binyoni in southern Uganda topped the list. With the DRCongo still closed for Westerners without an embassy-obtained visa and Burundi quite far by car, the “lake of a thousand islands” - at a distance of only 3.5 hours from Kigali - seemed perfect for a long weekend trip.
Binyoni, which is close to Uganda’s Bwindi Impenetrable Forest and its dwindling population of mountain gorilla,
While most locals get around in dug-out canoe…
…we decided to take a motorboat, in order to get to our lodge by sunset.
And what a great decision it was! The sky turned from a spectacular blue tinged with pink, to an overpowering suffusion of rose tones that took over every surface.
As we sat on our balcony, pictured in the dark above, the sky slowly passed through pink to red, making the water flicker like fire. It was unreal
There isn’t much to do in Binyoni, so most of the next day was spent reading books, laying on the dock, eating and then eating again: many elements of a successful mini-vacation.
Now, time for an awkward self-photo. Hi Grandma!
We eventually had to return to the world of the living, passing lush green tea plantations and high terraced hills. 3.5 hours, one border crossing, and zero trouble later, we were back. Hello, Kigali
By now you’ll realize that I’ve gotten a bit behind in my blog entries, and as such I won’t include “flashback” in the title here. That said, I left Malawi on September 22nd, so what you’re seeing here is evidence of some serious procrastination.
Enough said: on to the Malawian consumer experience, or something approximating it. Malawi has some of the most interesting markets I saw in East Africa. Sprawling, well-organized and furnished with strangely exciting stick bridges, I only wish I could have taken more photos without making people feel awkward. As it was, because I never wanted to shove a camera in someone’s face, I followed a few simple rules:
1. Photos of inanimate objects without people nearby: generally ok [example: aforementioned strangely exciting bridge]
2. Photos which were requested by the subject [examples: this small-goods vendor, or the man who charged the $0.06 toll over the bridge]
3. Sneaky photos taken with my camera slung over my shoulder by employing a delayed-capture setting, then surreptitiously pressing the button and looking away. Pros: people had no idea a picture was being taken. Cons: A lot of these photos are of the ground, my feet, or other similarly exciting objects. [Example: women selling beans and carrots in the produce section; secondhand clothes vendor]
Despite standing out like a sore thumb as one of few mzungus, I generally found people to be extremely warm and welcoming. I met many people who were also incredibly hard-working in a way that put me to shame. Some of them, often women, walked up to 20 kilometers each day, carrying vegetables or goods for sale in exquisitely balanced bundles.
I don’t think I bought much of anything, preferring instead the woodcarvers’ market in a different part of Old Town, but I certainly enjoyed looking!
It was perhaps one of my favorite experiences in Malawi.
However, if markets seemed too overwhelming for some expats, there were also plenty of places to buy fresh produce on the side of the street…
You can even buy quite a lot without getting out of your car!
Handcrafted wire objects, like the car these two boys have below, are another popular roadside, out-of-the-car-window purchase
Lastly, if shopping isn’t your thing, there’s plenty of vaguely Biblical, somewhat creepy political advertising to keep you entertained while everyone else stocks up on kanga fabric, tomatoes or wire souvenirs. Just don’t be fooled by His Excellency
+ Going barefoot in Kigali
+ Plastic bags (ziplock bags, grocery bags…yeah)
+ Street food
Ask me in person for some of the other things that are illegal, which I can’t post about here
You may remember my September visit to Kampala as one of market trips, weekend whitewater rafting and giant tubs of peanut butter. Despite all appearances, I actually had an ‘official’ purpose for being there: PATH’s first annual HPV and Cervical Cancer Prevention Workshop, which I was attending in support of the Rwandan MOH.
Super awkward picture, no?
Despite more than a few bizarre business interactions and a small case of food poisoning, the conference was great. Given how much time I’ve been in the past few months working on HPV vaccine introduction and cervical cancer screening and treatment programs, it was really valuable to see:
1. That the latest research confirms most of the decisions we’ve made in Rwanda
2. That there are a few places we should change course or tweak details, to take advantage of findings from demonstration projects in nearby Uganda
3. That various African countries are approaching HPV vaccine introduction & cervical cancer prevention in different ways, but there are a lot of places where one country’s experience can really help or inform another
It was also quite fun to see my work and slides projected to over 100 people — and I got a little ‘shout out’ from the Rwandan presenter
Like my McKinsey-style cervical cancer algorithm up there? Win at life!
Swaziland: it’s a cool place. Despite having few intelligent or interesting things to say about it, I actually did really enjoy my time here.
To be honest, we initially came for the passport stamp and the promise of staying on a hostel in the middle of a game reserve.
Which we did.
No catapults! Think I might have posted one of these photos earlier. There were also lots of hippos
And cool crafts, in nearby towns
All in, it was a blast… just don’t talk politics, or criticize the Swazi king’s habit of taking multiple teenage wives!
